WO2017080131A1 - Dispositif de fixation intramédullaire qui peut favoriser efficacement la guérison d'une fracture - Google Patents

Dispositif de fixation intramédullaire qui peut favoriser efficacement la guérison d'une fracture Download PDF

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Publication number
WO2017080131A1
WO2017080131A1 PCT/CN2016/077139 CN2016077139W WO2017080131A1 WO 2017080131 A1 WO2017080131 A1 WO 2017080131A1 CN 2016077139 W CN2016077139 W CN 2016077139W WO 2017080131 A1 WO2017080131 A1 WO 2017080131A1
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WO
WIPO (PCT)
Prior art keywords
fixation device
fracture healing
intramedullary fixation
device capable
short
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Application number
PCT/CN2016/077139
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English (en)
Chinese (zh)
Inventor
陈伟
张英泽
杜晨光
侯志勇
张世强
Original Assignee
陈伟
张英泽
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Priority claimed from CN201520902060.2U external-priority patent/CN205144700U/zh
Priority claimed from CN201510773308.4A external-priority patent/CN105232136A/zh
Application filed by 陈伟, 张英泽 filed Critical 陈伟
Publication of WO2017080131A1 publication Critical patent/WO2017080131A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices

Definitions

  • the invention relates to an intramedullary fixation device for fixing and promoting healing of a fracture, and belongs to the technical field of orthopedic medical devices.
  • a more general effect is the effect of the volumetric space-occupying effect of the internal fixation on the growth and continuity of the trabecular bone at the two fracture ends.
  • the trabecular bone in the human skeleton has an important function, which connects the surrounding cortical bone and enhances the overall strength of the bone. In addition, it constitutes an important mechanical conduction and transformation function in the medullary cavity, which can make the force more stress when the cortical bone is subjected to various loads. Balanced and reasonable, and spread and distribute local excessive load to other parts. Taking the proximal femur as an example, there is a neck dry angle of about 110°-140° between the femoral neck and the femoral shaft.
  • the femoral neck axis and the femoral condyle form a femoral neck anteversion angle, so the femoral neck is subjected to pressure, tension and Shear force.
  • a truss structure consisting of a pressure trabecular bone and a tension trabecular system in the femoral neck, transforming the bending moment and torque it receives and transmitting it to the backbone, dispersing local stress and reducing the risk of fracture; if there is no such truss in the proximal femur Structure, when the femoral shaft under the action of violence, the femoral neck will bear a large bending moment and torque, and the risk of fracture is higher.
  • trabecular bone can effectively restore the intramedullary blood supply system and contribute to the healing of cancellous and cortical bone. If the trabecular bone structure is unable to recover after the interruption, the intramedullary and extramedullary epiphysis growth is unbalanced during the fracture healing process, especially in the elderly. Osteoporotic fracture may occur after the cortical bone is healed, and the bone canal healing is poor, which affects the bone healing strength. And conduction to normal load, sometimes leading to delayed fracture healing, non-union or re-fracture.
  • the proximal end of the long bone marrow internal fixation system is relatively large, the structural damage of the trabecular bone is more serious, and the placement effect is more obvious, which affects the growth of the trabecular bone, which is not conducive to the recovery of bone structure in the later stage.
  • the bones strive to achieve an optimal structure, that is, the shape and material of the bone are regulated by the level of individual activity, so that it is sufficient to bear the mechanical load, but does not increase the burden of metabolic transport.
  • the change rule of the fracture remodeling process shows that if there is a displacement after the fracture, The concave side will have significant osteophyte formation, the internal trabecular bone will be aligned along the direction of transmission of compressive stress, and the bone will be absorbed on the convex side.
  • femoral neck fractures intertrochanteric fractures, distal femoral fractures, and proximal humeral fractures are common clinical injuries.
  • gamma nails, hollow (tension) screws, etc. are needed for the main complications. Including fracture nonunion, delayed healing, loose internal fixation, and fracture.
  • the technical problem to be solved by the present invention is to provide an intramedullary fixation device capable of promoting fracture healing.
  • the intramedullary fixation device utilizes the theory of bionic internal fixation to make the fracture recovery follow the conduction and load characteristics of the fracture itself, and can make the fracture treatment Achieve satisfactory restoration and healing effects.
  • the present invention adopts the following technical solutions:
  • an intramedullary fixation device capable of promoting fracture healing, characterized in that the intramedullary fixation device comprises a plurality of short cylinders and a plurality of connecting structures, and the plurality of short cylinders are spaced apart from each other; A plurality of connecting structures respectively connect the adjacent two of the short cylinders, each of the connecting structures having a plurality of spaces for the growth of the trabecular bone.
  • the short cylinder has a cross-sectional shape that is circular, elliptical or conformal to the curvature of the bone.
  • the short cylinders are 2-10.
  • the shortest end of the short cylinder is provided with a thread.
  • the connecting structure comprises a plurality of columns arranged in a gap with each other, and two ends of each column are respectively connected to two adjacent short cylinders, and an adjacent two columns are formed between The space in which the trabecular bone grows.
  • the plurality of columns are evenly distributed along the circumferential direction of the barrel, and the columns are parallel to the center line of the short barrel.
  • the columns between adjacent two short cylinders are 2-50.
  • the connecting structure further includes a plurality of tie rods, two ends of each of the tie rods are respectively connected to two adjacent short barrels, and an adjacent shaft and a column are formed for the bone The space in which the trabeculae grow.
  • the pull rod is a diagonal rod or a crossed double rod.
  • the connecting structure is a three-dimensional network cross-linked body having a plurality of mutually communicating holes on the three-dimensional network cross-linked body to form the space for the growth of the trabecular bone.
  • the cross-sectional shape of the pores of the three-dimensional network cross-linked body is circular, elliptical or polygonal.
  • the intramedullary fixation device capable of promoting fracture healing of the present invention is formed by connecting a plurality of short cylinders and a plurality of columns, the short cylinder can provide sufficient support strength, and the joint structure has a plurality of spaces for the growth of the trabecular bone.
  • the intramedullary fixation device of the invention can allow the trabecular bone to grow along the space of the connecting structure, achieve the simultaneous growth of the intramedullary and extramedullary epiphyses, shorten the fracture healing time, restore the physiological and mechanical characteristics, and reduce various complications of fractures and operations.
  • the invention can promote the fracture healing of the intramedullary fixation device, utilizes the bionic internal fixation theory, adopts a novel bionic intramedullary fixation device which is more in line with the anatomical structure of the bone and the biomechanical structural characteristics, so that the fracture recovery follows the conduction and load characteristics of the fracture itself. It can achieve satisfactory reduction and healing effects in fracture treatment.
  • FIG. 1 is a schematic structural view of an embodiment of an intramedullary fixation device capable of promoting fracture healing according to the present invention
  • Figure 2 is a cross-sectional view taken along line A-A of Figure 1;
  • Fig. 3 is a schematic view showing the structure of another embodiment of the intramedullary fixation device capable of promoting fracture healing according to the present invention.
  • Fig. 4 is a partial perspective view of the connecting structure in the intramedullary fixation device of Fig. 3 capable of promoting fracture healing.
  • the figure is marked as follows: short cylinder 1, column 2, tie rod 3, thread 4, and three-dimensional network crosslinked body 5.
  • FIG. 1 is a schematic structural view of an embodiment of an intramedullary fixation device capable of promoting fracture healing according to the present invention
  • FIG. 2 is a cross-sectional view taken along line A-A of FIG.
  • An embodiment of the intramedullary fixation device capable of promoting fracture healing of the present invention comprises a plurality of short cylinders 1 spaced apart from each other and a plurality of connection structures arranged at a distance from each other.
  • the plurality of connecting structures respectively connect the adjacent two short cylinders 1, each connecting structure having a plurality of spaces for the growth of the trabecular bone.
  • the height of the short cylinder 1 can be less than or equal to the height of the connection structure.
  • the height of the short cylinder 1 can be, for example, between 5 and 300 mm.
  • the plurality of short cylinders 1 are all cylindrical and have the same diameter, and the plurality of short cylinders 1 are arranged up and down along the central axis, and the number of the short cylinders 1 is 2-10.
  • the intramedullary fixation device of different lengths can be used, and the intramedullary fixation device of a suitable length can be selected according to actual needs.
  • the diameter and length of the intramedullary fixation device can be the same as conventional intramedullary nails used in general surgery.
  • the cross-sectional shape of the short cylinder 1 may be an elliptical shape or a shape conforming to the local curvature of the bone, for example, the short cylinder 1 is a tapered cylinder or the like. Different shapes of the short cylinders 1 can be arbitrarily combined.
  • the connecting structure comprises a plurality of columns 2 arranged at a mutual gap, and two ends of each column 2 are respectively connected to two adjacent short cylinders 1, and an adjacent two columns 2 are formed.
  • the plurality of columns 2 are evenly distributed along the circumferential direction of the cylinder, and the columns 2 are parallel to the center line of the short cylinder.
  • the column between the adjacent two short cylinders 1 is 2-50.
  • the connecting structure further includes a plurality of tie rods 3, two ends of each of the tie rods are respectively connected to the adjacent two short cylinders 1, and are located between the adjacent two columns 2, between the adjacent tie rods 3 and the columns 2 Form a space for the growth of the trabecular bone.
  • the drawbar can be a diagonal rod or a crossed double rod.
  • the tie rod 3 can increase the strength and stability of the intramedullary fixation device, and can improve the overall elastic modulus of the intramedullary fixation device, and the internal fixation strength is enhanced to prevent breakage, stress fracture, and the like.
  • the inner wall of the short barrel 1 at the lowermost end of the intramedullary fixation device has a thread 4 which can be matched with the thread of the front end of the handle of a take-up device, thereby facilitating the operator to complete the insertion. And remove the fracture after healing.
  • the short cylinder 1 and the column 2 and the tie rod 3 of the present invention can be fabricated by 3D printing technology or by integral casting.
  • connection structure between the short cylinders 1 of the invention can allow the trabecular bone to grow along the space connection between the column 2 and the tie rod 3, to achieve simultaneous growth of the intramedullary and extramedullary epiphyses, shorten the fracture healing time, and reduce various fractures and operations. complication.
  • the intramedullary fixation device with 2-10 columns 2 and diagonal tie rods 3 is suitable for the elderly population. More than 10 column 2 and oblique rods 3 are more suitable for the young and middle-aged people. .
  • FIG. 3 is a schematic structural view of another embodiment of the intramedullary fixation device capable of promoting fracture healing according to the present invention
  • FIG. 4 is a connection structure of the intramedullary fixation device capable of promoting fracture healing shown in FIG. Partial perspective view.
  • the intramedullary fixation device of this embodiment includes a plurality of short barrels 1 and a plurality of connection structures. This embodiment differs from the actual intramedullary fixation device shown in Figure 1 only in that:
  • the connecting structure is a three-dimensional network cross-linked body 5 having a plurality of mutually communicating holes 51, and the mutually communicating holes 51 form a space for the growth of the trabecular bone.
  • the cross-sectional shape of the hole 51 of the three-dimensional network cross-linking body may be circular, elliptical, polygonal or other shapes.
  • the invention utilizes the bionic internal fixation theory and adopts a novel bionic intramedullary fixation device which is more in line with the anatomical structure of the bone, especially the biomechanical structure, so that the fracture recovery follows the conduction and load characteristics of the fracture itself, and the fracture treatment can be satisfactorily reset and healing effect.
  • the invention is an innovation of the fracture reduction and fixation technique, and solves the problem that the bone canal healing is poor, especially affecting the bone healing strength after the treatment of osteoporotic fracture in the elderly, and sometimes the fracture may be delayed and the fracture is difficult. .
  • microporous bionic fracture intramedullary fixation device of the invention is suitable for internal fixation of long bone fractures, especially for complex trabecular bone fractures near the joint, combined with minimally invasive techniques and image navigation technology support, has good expectations and can be obtained. Significant economic and social benefits.
  • the intramedullary fixation device capable of promoting fracture healing of the present invention is formed by connecting a plurality of short cylinders and a plurality of columns, the short cylinder can provide sufficient support strength, and the joint structure has a plurality of spaces for the growth of the trabecular bone.
  • the intramedullary fixation device of the invention can allow the trabecular bone to grow along the space of the connecting structure, achieve the simultaneous growth of the intramedullary and extramedullary epiphyses, shorten the fracture healing time, restore the physiological and mechanical characteristics, and reduce various complications of fractures and operations.
  • the invention can promote the fracture healing of the intramedullary fixation device, utilizes the bionic internal fixation theory, adopts a novel bionic intramedullary fixation device which is more in line with the anatomical structure of the bone and the biomechanical structural characteristics, so that the fracture recovery follows the conduction and load characteristics of the fracture itself. It can achieve satisfactory reduction and healing effects in fracture treatment.

Abstract

La présente invention concerne un dispositif de fixation intramédullaire qui peut favoriser la cicatrisation d'une fracture, caractérisé en ce que : le dispositif de fixation intramédullaire comprend une pluralité de cylindres courts (1) et une pluralité de structures de raccordement, dans lequel la pluralité de cylindres courts (1) sont agencés de façon décalée, la pluralité de structures de raccordement sont respectivement raccordées aux deux cylindres courts adjacents (1), et chaque structure de raccordement comporte une pluralité d'espaces où des trabécules osseux peuvent croître. Le dispositif de fixation intramédullaire qui peut favoriser la cicatrisation d'une fracture est réalisé par l'interconnexion de la pluralité de courts cylindres (1) et une pluralité de colonnes verticales (2), les courts cylindres (1) pouvant conférer suffisamment de force de support, et les structures de raccordement comportent la pluralité d'espaces où des trabécules osseux peuvent croître. Le dispositif de fixation intramédullaire peut permettre aux trabécules osseux de croître le long et dans les espaces des structures de raccordement, de sorte que les cals osseux intramédullaires et extramédullaires puissent croître simultanément, de manière à réduire le temps de cicatrisation de fracture, récupérer les propriétés mécaniques et physiologiques, et réduire les complications avec des fractures et l'opération.
PCT/CN2016/077139 2015-11-13 2016-03-23 Dispositif de fixation intramédullaire qui peut favoriser efficacement la guérison d'une fracture WO2017080131A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN201520902060.2U CN205144700U (zh) 2015-11-13 2015-11-13 一种能有效促进骨折愈合的髓内固定装置
CN201510773308.4 2015-11-13
CN201520902060.2 2015-11-13
CN201510773308.4A CN105232136A (zh) 2015-11-13 2015-11-13 一种能有效促进骨折愈合的髓内固定装置

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WO2017080131A1 true WO2017080131A1 (fr) 2017-05-18

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI700073B (zh) * 2018-05-02 2020-08-01 國立中山大學 骨植入物

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1582161A1 (fr) * 2004-03-31 2005-10-05 Orthofix International B.V. Clou intramedullaire avec des moyens de fixation d'expansion appuyent par un ou plusieurs éléments d'entraínement
CN101636119A (zh) * 2007-03-22 2010-01-27 诺瓦利恩整形公司 分节髓内结构
US20100094292A1 (en) * 2008-10-14 2010-04-15 Zimmer, Inc. Modular intramedullary nail
US20110077651A1 (en) * 2009-09-28 2011-03-31 Zimmer, Inc. Expandable intramedullary rod
CN105232136A (zh) * 2015-11-13 2016-01-13 陈伟 一种能有效促进骨折愈合的髓内固定装置

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1582161A1 (fr) * 2004-03-31 2005-10-05 Orthofix International B.V. Clou intramedullaire avec des moyens de fixation d'expansion appuyent par un ou plusieurs éléments d'entraínement
CN101636119A (zh) * 2007-03-22 2010-01-27 诺瓦利恩整形公司 分节髓内结构
US20100094292A1 (en) * 2008-10-14 2010-04-15 Zimmer, Inc. Modular intramedullary nail
US20110077651A1 (en) * 2009-09-28 2011-03-31 Zimmer, Inc. Expandable intramedullary rod
CN105232136A (zh) * 2015-11-13 2016-01-13 陈伟 一种能有效促进骨折愈合的髓内固定装置

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI700073B (zh) * 2018-05-02 2020-08-01 國立中山大學 骨植入物

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